Poop Is THE KEY To The Microbiome. Here’s Why.
by Marissa Pomerance and Tamara Jefferies
We don’t really want to talk about poop. But unfortunately, we have to talk about poop.
Because our poop can tell us a lot about our health. And so we’re going to attempt to give you all the info—no baby talk, no cutesy (or overly graphic) BS. Just a frank, honest discussion about poop. But also sort of fun.
Here’s the ugly truth; your poop can be a huge marker for how well your diet and lifestyle are working for your body. But more importantly, it can provide a window into what’s happening in your gut, and more specifically, your microbiome. And it might just hold the answers to some of our most frustrating medical conundrums.
The basics of “healthy” poop.
We all pretty much know the basics, right? Unless your stomach is made of iron, you’ve undoubtedly suffered through enough digestive distress to understand that constipation, diarrhea, and off-colored stools are bad. While poop color, consistency, and regularity can indicate various health issues—from celiac disease to IBS—they’re essentially all signs that your digestive system is unhappy.
If your poop is healthy, it will be well-formed, easy to pass (you should never have strain, as this can cause hemorrhoids), and should empty the colon completely. And according to Wendie Trubow, M.D., a doctor of functional medicine, "at a minimum, one is expected to have a bowel movement once a day, but it could easily be three times in a day if the gut is functioning well."
If you’re pooping regularly and easily, then great. If not, your poop might reflect a compromised microbiome.
Why is everyone suddenly obsessed with the microbiome?
Here’s where things get interesting.
If it seems like everyone is talking about the microbiome, that’s because there have been tons of promising studies and research examining the connection between a plethora of health conditions and the gut microbiome—an array of micro-organisms including bacteria, fungi, viruses and other microbes that live in your digestive tract (which is made up of the mouth, esophagus, stomach, pancreas, liver, gallbladder, small intestine, colon, and rectum).
We have 300-500 different species of bacteria (creating a total of trillions overall) living in our gut, and while some might be harmful, plenty are necessary for maintaining our health. Some microbes help break down food, produce vitamins, and keep dangerous bacterial growth under control. Overall, a greater diversity of gut microbes has been linked to a longer, healthier life. But unfortunately, modern diets rich with processed foods, environmental factors, and antibiotics can all affect our delicate gut flora, creating imbalances that make us ill.
Unsurprisingly, this careful balance of bacteria in the gut can affect our chances of developing gastrointestinal conditions and diseases. An imbalance, in which there are more unhealthy than healthy microbes, is often referred to as “gut dysbiosis,” and it’s been associated with weight gain, obesity, diabetes, high blood sugar, and IBS.
But what might surprise you is that conditions seemingly unrelated to the digestive tract—like autoimmune diseases, skin conditions, cancer, and endocrine disorders-- have been linked to the gut microbiome.
Our gut health even impacts our mental health—a phenomenon that has become known as the “gut-brain axis.” Low levels of certain beneficial bacteria has been linked to depression, while one study demonstrated that consistent use of probiotics had as much of a positive impact on people’s moods as prescribed anxiety medication.
Microbiome research has also shown that kids with autism, who are eight times more likely to have digestive problems than kids without autism, have abnormal or less diverse intestinal bacteria, providing new potential pathways for autism experimentation and treatment.
But how does an imbalanced gut microbiome wreck our bodies? According to Dr. Tieraona Low Dog, “disruption of the microbiome can cause the immune system to overreact and contribute to inflammation, leading to the development of symptoms of disease that occur throughout your body, including your brain."
Essentially, the gut microbiome might be The Key to understanding a diverse range of health issues, and science is only just beginning to study and understand it.
What does this have to do with poop?
First, if you happened to read anything we just wrote about the microbiome, then its effect on your poop will seem pretty obvious. A disrupted gut microbiome can lead to gastrointestinal distress, which can be expressed by your poop. Constipation, diarrhea, black and tarry stools, etc; these can all be signs of underlying disease and digestive issues, which may be linked to your balance of gut flora.
Second, this needs to be said; half the dry weight of poop is made up of bacteria. HALF! So examining and studying the bacteria found in poop is a helpful tool for determining microbiome diversity and richness, which, as we mentioned earlier, is associated with better overall health.
While simply looking at our poop can tell us that something is amiss, poop testing can give scientists and doctors a more in-depth look at what’s happening in our guts on a cellular level. Daniel McDonald, Scientific Director at the American Gut Project (which, yes, IS a thing), studied poop samples from 10,000 participants to draw conclusions about the gut microbiome. What a fun job.
The project found that a greater variety of plants in someone’s diet was correlated with a greater diversity of microbes in their gut. They also discovered that the microbial diversity in samples from recent antibiotic users was much lower than individuals who hadn’t used antibiotics for at least a year. The benefits of more plants and fewer antibiotics might not seem revelatory, but remember—this was all discovered through poop.
Poop can be transformative.
Yes, it really can be. Hear us out—as much as poop testing can tell us about the human microbiome, the real frontier of the poop-microbiome relationship is fecal transplants. Which is, unfortunately, as gross as it sounds. Though these procedures date back centuries, they’re now becoming more mainstream thanks to a variety of testing and studies demonstrating their *magic.*
Fecal transplants seem relatively straight-forward; a patient with a disrupted gut microbiome is given via enema, colonoscopy, or similar means, a transfer of stool from a healthy person. This healthy fecal matter will alter the sick patient’s microbiome to reflect that of the donor. Though studies are still examining the long-term effects of fecal transplants, initial testing has demonstrated positive changes to the patient’s gut microbiome after just a few weeks, with a healthier balance of good to bad bacteria.
But fecal transplants are actually pretty complex treatments. Most doctors will perform rigorous testing on the healthy fecal matter before administering it, ruling out potential donors with infections like HIV or Hep-C, or even a family history of medical conditions like heart disease, obesity, or liver disease. Companies like OpenBiome have sprung up around this fecal transplant fervor, aiming to provide safe fecal samples from healthy donors.
So far, fecal transplants have found success in trials (but not FDA approval) with curing persistent C. difficile infections, which is a frustrating and difficult-to-treat infection affecting the GI tract. In fact, these transplants have cured 90% of patients with serious, recurring C. difficile infections that didn’t respond to antibiotics. And if you don’t believe me, check out this personal account of receiving a fecal transplant for a recurring C. diff infection.
But the real *magic* is happening behind-the-scenes, where a growing number of clinical trials are examining whether fecal transplants can treat conditions from HIV to diabetes and even Alzheimer’s.
In one study, fecal transplants in autistic children were shown to improve their gastrointestinal issues, as well as their autism symptoms, over a two-year period. An individual case reported by gastroenterologist Colleen Kelly saw a patient with long-term, aggressive alopecia grow hair after a fecal transplant from his sister. And in a study in Israel, fecal transplants from recovering cancer patients aided the recovery of other cancer patients, whose tumors had been previously resistant to traditional drug therapies.
Because fecal transplants are an emerging treatment, the medical community is still learning about the potential downsides. In one mind-boggling case, a 32-year-old woman suffering from C. difficile gained 41 pounds after receiving a fecal transplant from her daughter, despite a liquid diet and medically-supervised exercise regimen. Her daughter was slightly overweight at the time, and continued to gain 30 pounds after her mom’s procedure. Though her C. diff was cured, doctors believe that the daughter’s make-up of bacteria could have negatively impacted the mother’s metabolism, and now recommend sourcing fecal matter from non-obese donors.
Since the microbiome is an incredibly complex, rich, and diverse system, we’re still just beginning to understand the mechanisms of individual bacterial strains and the potential outcomes of each person’s unique makeup of microbes.
And poop is really just the beginning. “FMT is but the first step in the next journey to biologic treatment of disease,” explains Dr. Lawrence Brandt, Professor of Medicine and Surgery at Albert Einstein College of Medicine. “Once the role of bacteria in maintaining our health is better understood, and we identify how individual species, or groups of bacteria, or their metabolic products, protect us against specific diseases, we can fashion a designer cocktail of bacteria that can be taken like a probiotic—to cure a specific disease or even prevent it.”
Honestly, we’ve never been more excited by the words “poop” and “bacteria” in our entire lives.
Marissa Pomerance is the Managing Editor of The Candidly. She’s a Los Angeles native and lover of all things food, style, beauty, and wellness. You can find more of her articles here.
Tamara Jefferies is a So-Cal based freelance wellness copywriter. In her downtime, she’s testing out recipes from around the world or traveling and exploring new places with her partner. You can find more of her articles here.
